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Arkansas rates for HCPCS 28540

Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $794.33 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $199.53 / $281.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $208.93 / $288.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $213.80 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $275.42 / $331.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $346.74 / $776.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $218.78 / $338.84